Pioglitazasyonun testis iskemi reperfüzyon hasarı üzerine olan etkisinin incelenmesi
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Date
2020
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Trakya Üniversitesi, Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
Testis torsiyonu teşhis sonrasında hızlı şekilde tedavi gerektiren akut seyirli ürolojik acildir. Tedavi olarak yapılan detorsiyon işlemi sonrasında meydana gelen iskemi-reperfüzyon süreçleri de testiküler hasara neden olur. Çalışmamızın amacı pioglitazonun, testiküler iskemi reperfüzyon hasarında etkisini araştırmaktır. Bu amaçla dizayn ettiğimiz çalışmada; 48 adet Wistar-Albino sıçan randomize edilerek 8 eşit gruba ayrıldı. 1. grup kontrol grubu olup sadece orşiektomi yapıldı. 3. ve 5. grup ilaç grupları olup sırasıyla 3 mg/kg ve 6 mg/kg dozundan pioglitazon verildikten 2 saat sonra orşiektomi yapıldı. 2. grup iskemi reperfüzyon grubu idi. Bu gruba deneysel testis torsiyonu uygulanarak 4 saat beklendi. 4 saatlik torsiyon sonrası detorsiyon işlemi uygulandı. Detorsiyonun 4. saatinde orşiektomi yapıldı. 4. ve 6. gruplar deney grupları idi. Bu gruplara 2. gruptan farklı olarak torsiyonun 2. saatinde sırasıyla 3mg/kg ve 6 mg/kg dozundan pioglitazon verildi. Biyokimyasal olarak; testis dokusunda Malondialdehid (MDA ve Glutatyon (GSH) değerlendirildi. Histopatolojik olarak ise seminifer tübül çapları ve epitel kalınlıkları ölçüldü ve Johnsen skoru hesaplandı. Sonuçlar Kruskal Wallis ve Mann Whitney-U testi ile karşılaştırıldı. Biyokimyasal değerlendirmede iskemi reperfüzyon yapılan gruplarda MDA ve GSH iskemi yapılmayan gruplara göre anlamlı yüksek bulundu. Tedavi verilen gruplardan 3 mg/kg’dan pioglitazon verilen grupta tedavi verilmeyen gruba göre fark saptanmazken, 6 mg/kg pioglitazon verilen grupta bir miktar azalma görülmekle beraber anlamlı fark saptanmadı. Histopatolojik değerlendirmede ise iskemi reperfüzyon yapılan gruplarda seminifer tübül çapları, epitel uzunlukları ve Johnsen skoru iskemi reperfüzyon yapılmayan gruplara kıyasla anlamlı azalma gösterdi. Tedavi verilen gruplardan 3 mg/kg’dan pioglitazon verilen grupta tedavi verilmeyen gruba kıyasla fark saptanmazken, 6 mg/kg’dan pioglitazon verilen grupta seminifer tübül çapları ve epitel kalınlıkları anlamlı iyileşme gösterdi. Sonuç olarak; tek taraflı testis torsiyonunda 6 mg/kg pioglitazon tedavisinin iskemi reperfüzyon hasarına karşı koruyucu etkisi olduğunu söylenebilir.
Testicular torsion is an acute urological emergency that requires prompt treatment after diagnosis. Ischemic-reperfusion processes after detorsion also causes testicular damage. The aim of our study is to investigate the effect of pioglitazone on testicular ischemia reperfusion injury. In the study we designed for this purpose; 48 Wistar-Albino rats were randomized and divided into 8 equal groups. The first group was the control group and only orchiectomy was performed. Group 3 and 5 were drug groups, and orchiectomy was performed 2 hours after pioglitazone was given at a dose of 3 mg/kg and 6 mg/ kg, respectively. The second group was the ischemia reperfusion group. Experimental testicular torsion was applied to this group and it was waited for 4 hours. Detorsion procedure was applied after 4 hours of torsion. Orchiectomy was performed at the 4th hour of detorsion. Groups 4 and 6 were experimental groups. Unlike the second group, pioglitazone was administered to these groups at a dose of 3 mg/kg and 6 mg/kg, respectively, at the second hour of torsion. Biochemically; Malondialdehyde (MDA) and Glutathione (GSH) was evaluated in testicular tissue. Histopathologically, seminiferous tubule diameters and epithelial thickness were measured and the Johnsen score was calculated. Results were compared with Kruskal Wallis and Mann Whitney-U test. In the biochemical evaluation, MDA and GSH were found to be significantly higher in the ischemia reperfusion groups compared to the groups without ischemia. While there was no difference in the group treated with 3 mg/kg pioglitazone compared to the non-treated group, a slight decrease was observed in the group treated with 6 mg/kg pioglitazone, but no significant difference was found. In histopathological evaluation, seminiferous tubule diameters, epithelial lengths and Johnsen score showed a significant decrease in ischemia reperfusion groups compared to groups without ischemia reperfusion. While there was no difference between the treated groups and the group treated with 3 mg/kg pioglitazone compared to the untreated group, seminiferous tubule diameters and epithelial thickness improved significantly in the group given pioglitazone with 6 mg/kg. As a result; 6 mg/kg pioglitazone treatment could have a protective effect against ischemia reperfusion injury in unilateral testicular torsion.
Testicular torsion is an acute urological emergency that requires prompt treatment after diagnosis. Ischemic-reperfusion processes after detorsion also causes testicular damage. The aim of our study is to investigate the effect of pioglitazone on testicular ischemia reperfusion injury. In the study we designed for this purpose; 48 Wistar-Albino rats were randomized and divided into 8 equal groups. The first group was the control group and only orchiectomy was performed. Group 3 and 5 were drug groups, and orchiectomy was performed 2 hours after pioglitazone was given at a dose of 3 mg/kg and 6 mg/ kg, respectively. The second group was the ischemia reperfusion group. Experimental testicular torsion was applied to this group and it was waited for 4 hours. Detorsion procedure was applied after 4 hours of torsion. Orchiectomy was performed at the 4th hour of detorsion. Groups 4 and 6 were experimental groups. Unlike the second group, pioglitazone was administered to these groups at a dose of 3 mg/kg and 6 mg/kg, respectively, at the second hour of torsion. Biochemically; Malondialdehyde (MDA) and Glutathione (GSH) was evaluated in testicular tissue. Histopathologically, seminiferous tubule diameters and epithelial thickness were measured and the Johnsen score was calculated. Results were compared with Kruskal Wallis and Mann Whitney-U test. In the biochemical evaluation, MDA and GSH were found to be significantly higher in the ischemia reperfusion groups compared to the groups without ischemia. While there was no difference in the group treated with 3 mg/kg pioglitazone compared to the non-treated group, a slight decrease was observed in the group treated with 6 mg/kg pioglitazone, but no significant difference was found. In histopathological evaluation, seminiferous tubule diameters, epithelial lengths and Johnsen score showed a significant decrease in ischemia reperfusion groups compared to groups without ischemia reperfusion. While there was no difference between the treated groups and the group treated with 3 mg/kg pioglitazone compared to the untreated group, seminiferous tubule diameters and epithelial thickness improved significantly in the group given pioglitazone with 6 mg/kg. As a result; 6 mg/kg pioglitazone treatment could have a protective effect against ischemia reperfusion injury in unilateral testicular torsion.
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Keywords
İskemi Reperfüzyon Hasarı, Testis Torsiyonu, Pioglitazon, Ischemia Reperfusion Injury, Testicular Torsion, Pioglitazone
